Arrest outcomes associated with outpatient commitment in New York State

Area of Science:

• Forensic Psychiatry
• Public Health Law
• Mental Health Services Research

Background:

• Assisted outpatient treatment (AOT) is a legal mechanism designed to mandate psychiatric treatment for individuals with severe mental illness who often disengage from voluntary care.
• Kendra's Law in New York State provides a legal framework for AOT, allowing court orders for treatment to prevent relapse and reduce negative outcomes.
• High rates of arrest and criminal justice involvement are common among individuals with severe mental illness who do not receive consistent treatment.

Purpose of the Study:

• To investigate the association between New York's Kendra's Law and the rate of arrests for violent and nonviolent offenses among individuals with severe mental illness.
• To compare arrest rates before, during, and after AOT assignment, as well as between individuals who received AOT and those who did not.

Main Methods:

• Retrospective analysis of arrest records for 183 participants in New York City outpatient clinics over 16,890 observation months.
• Comparison of arrest rates using generalized estimating equations and fixed-effects analyses, differentiating periods before, during/shortly after, and >6 months after AOT assignment.
• Inclusion of participants who were ever assigned to AOT (n=86) and those never assigned (n=97).

Main Results:

• Individuals receiving AOT experienced significantly lower odds of any arrest (2.66 times lower) and violent offense arrest (8.61 times lower) during and shortly after AOT compared to the period before AOT.
• The group never assigned to AOT had nearly double the odds of arrest (1.91 times higher) compared to the AOT group during the period of AOT assignment.

Conclusions:

• Outpatient commitment under Kendra's Law is linked to a reduced risk of arrest for individuals with severe mental illness.
• The mandatory nature of AOT may serve as a crucial intervention, potentially averting more severe legal consequences within the criminal justice system.
• AOT represents a valuable public health strategy for managing severe mental illness and reducing associated criminal justice system contact.